Focus on Compliance The Power of Two Pharmacy

SH A R I NG
T H A - E n d o r s e d
P r o d u c t s
a n d
S e r v i c e s
Vo l u m e 3 , N o. 3
Fall 2011
Pharmacy Staffing
The Power of Two
On-Site and Remote Solutions
For Rural Hospitals
Unique Partnership Creates
Successful Staffing Solution
Focus on Compliance
Improving Documentation,
Bringing Up the Bottom Line
T H A - E n d o r s e d P r o d u c t s a n d Se r v i c e s
A
M e s s a g e
f r o m
the
C E O
Fall is almost here, and with it comes the return of football, cooler
temperatures (I can dream) and the HealthSHARE Summit. Each
year, HealthSHARE hosts a meeting for representatives from Texas
Hospital Association-endorsed companies at the THA headquarters
in Austin. The two-day event provides an opportunity for these representatives to learn how to make the most of the coveted endorsed
status. Session topics include everything from the benefits of sponsoring THA education
events to the best way to approach hospital decision-makers.
As one of these decision-makers yourself, you may have some valuable tips. What’s
the best way to get in the door at your hospital? Is there anything a company should
definitely not do? How can a company earn your trust?
If you have any do’s and don’ts you’d like to share for the summit, or if you’d like
to provide feedback on anything in this issue of Sharing, please don’t hesitate to let me
know. Feel free to contact me at jdixon@tha.org.
James M. Dixon
President/Chief Executive Officer
SH A R I NG
Vo l u m e 3 , N o. 3
Fall 2011
HealthSHARE President/Chief Executive Officer
James M. Dixon
Co n t e n t s
Vice President
Brian Stevens
Project Advisor, Business Development
Miles Pequeno
Editor
Debbie Ritenour
Contributors
Karen Branz
Geoff Camphire
Sue Durio
Terri Schexnayder
Art Director
Barbara Battista
7
The Power of Two
8
Pharmacy Staffing
9
Focus on Compliance
Unique Partnership Creates Successful Staffing Solution
On-Site and Remote Solutions for Rural Hospitals
HealthSHARE Board of Directors
Chairman
Tim Lancaster, FACHE
Vice Chair
Michael McAndrew, FACHE
Improving Documentation, Bringing Up
the Bottom Line
Secretary
James M. Dixon
Stephen Bowerman
Keith L. Butler
Ronald D. Davis
Ernest Flores Jr.
Robert G. Haynes, FACHE
Lance W. Keilers
David S. Lopez, FACHE
Robert Marshall
John L. Simms
Steven L. Smith
Dan Stultz, M.D., FACP, FACHE
Jeff R. Turner, FACHE
© 2011 all rights reserved. Sharing is published four times
a year by HealthSHARE, a wholly owned subsidiary of the
Texas Hospital Association, 1108 Lavaca, Suite 600, Austin,
Texas 78701, 512/465-1070, fax 512/692-2709.
No part of this publication may be reproduced in any form
without written permission of the publisher. Opinions
expressed in this publication do not necessarily reflect
official policy of HealthSHARE or THA.
www.healthshare-tha.com
Inside This Issue
Spotlight: Reimbursement Services............................... 4
News Roundup................................................................ 6
HealthSHARE Highlights and The Bottom Line......... 10
Texas Hospital Association-Endorsed Companies.....11
s p o t l igh t : R e i m b u r s e m e n t S e r v i c e s
As a wholly owned subsidiary of the Texas
Hospital Association, HealthSHARE markets
best-of-breed, competitively priced products
and services offered through THA-endorsed
companies that benefit hospitals’ quality,
service and bottom line. Each issue of Sharing
spotlights a different category of services.
This issue, the spotlight is on reimbursement
services.
Auditz LLC
Auditz provides revenue enhancement
solutions to hospitals. The Auditz Payer
Search system links directly with Medicare,
Medicaid and Tricare through a proprietary
electronic data interchange connection to
reconstruct inaccurate patient demographic
information and query for eligibility. The
technology continues to examine the account data and looks for eligibility through
to the conclusion of timely filing limits.
The report also returns primary commercial
insurance where identified in the Medicare
and Medicaid systems. The search is not
limited by a dollar threshold.
Jim Stuart
813/387-0317
jstuart@auditz.com
www.auditz.com
CampbellWilson
CampbellWilson provides financial, operational, compliance and regulatory consulting to hospitals and health care providers.
The company is recognized nationally for
assisting providers with reimbursement
and overall hospital operational improvements. Its consultants include CPAs, RNs,
health care attorneys, litigation and appeals specialists, systems and management
engineers, government reimbursement
and regulatory compliance experts, certified professional coders, registered health
information administrators and revenue
cycle experts. Its solutions have helped
clients increase revenues by $2 billion and
returned an additional $500 million in
recovered Medicare and Medicaid revenues
to providers.
Manie Campbell
800/723-6492
mcampbell@campbellwilson.com
www.campbellwilson.com
Craneware Inc.
Healthcare Recovery Alliance
Craneware provides automated revenue
integrity solutions that improve financial
performance for health care organizations.
Craneware’s market-driven software-as-aservice solutions help hospitals and other
health care providers more effectively price,
charge and code for services and supplies
associated with patient care. This optimizes
reimbursement, increases operational
efficiency and minimizes compliance risk.
By partnering with Craneware, clients
achieve the visibility required to identify,
address and prevent revenue leakage.
Complicated claims, confusing rules and
regulations, loopholes and incorrect payments all factor into why hospitals aren’t
always reimbursed at the levels they should
be. Healthcare Recovery Alliance offers
accounts receivable management strategies
that can accelerate a hospital’s revenue
cycle. Its services include review of workers’
compensation accounts against statemandated schedules and guidelines, identification of managed care contracts, review
of claims against applicable contracts,
and submission of any discrepancies for
payment and appeals. The firm’s program,
tailored to each hospital, applies whether
the problem is due to staff shortages or
build-up of aged receivables.
Jacob Nguyen
602/684-3099
j.nguyen@craneware.com
www.craneware.com
eTactics Inc.
eTactics’ Patient Payment Program reduces
administrative costs, improves accounts
receivable and increases collections. The
company’s ability to analyze statement
data and enclose custom cover letters is
an example of the proactive action that
collects accounts before they become
delinquent. Patient account data can be uploaded to Etactics’ secure website, processed
in a patient-friendly format, and printed
and mailed by the following business day.
The Patient Payment Program has increased
patient revenue by as much as 25 percent
while reducing billing questions and the
number of statements mailed by the same
amount.
Paul Osiecki
214/213-1685
posiecki@etacticsinc.com
www.etacticsinc.com
Financial Review
Services Inc.
Financial Review Services’ program of total
quality management recognizes and fixes
the problem of lost revenue. It features a
three-phase revenue recovery program:
Phase I – a lost charge audit; Phase II –
nurse training and action plan development;
and Phase III – a follow-up audit, which
ensures the action plan and training is
implemented and effective.
Mike Lewis
713/850-7456
mplewis@wt.net
www.checkfrs.com
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S H A R I N G / Fall 2 0 1 1
Mike Stewart
800/710-2825
mstewart@hcralliance.com
www.hcralliance.com
HealthXnet
HealthXnet provides a simple, cost-effective
way to perform eligibility/benefits, claims
status and electronic claims management
revenue cycle transactions. Outstanding
system reliability, ease of use and responsive customer service make HealthXnet
stand out from its competitors. Hospital
staff can perform transactions on the company’s Web portal with little to no training
and often are using the system within 2-3
business days of subscription. A free no-risk
trial is available for inquiry transactions,
and there is never a long-term commitment.
Brett Weinstein
512/346-0222
bweinstein@nmhsc.com
www.healthxnet.com
Hospital Receivables
Services Inc.
Hospital Receivables Services’ collections
and accounts receivables services bring accounts up-to-date and help hospitals keep
them current. The company is a 501(c)(3)
nonprofit cooperative owned by the facilities it serves, which share in the company’s
profits. HRS provides receivables management, account termination, preferred
billing for “early outs” and long-term
accounts, collections seminars, detailed
reports and prompt remittance.
Doug Smith
800/955-8722
douglasismith@sbcglobal.net
www.hospitalreceivables.org
Integrated Revenue
Management
Integrated Revenue Management helps
hospitals find the money that’s hiding in
the revenue cycle. The company’s unique
in-sourcing approach of teaching organizations to fish by establishing a new or
enhancing an existing revenue integrity
department delivers immediate and ongoing results of $300,000 to $500,000 in
additional net revenue per dedicated staff
member per year. Starting with a review
of the effectiveness of a hospital’s revenue
cycle and interview of key stakeholders,
IRM uncovers the opportunity, builds the
business case and delivers the services for
a revenue integrity department that helps
hospitals identify, capture and collect the
full value of each service performed.
Thomas E. Wolfe
760/448-1039
twolfe@irminconline.com
www.irminconline.com
MedA/Rx
MedA/Rx specializes in revenue cycle
management and extended business office
services. MedA/Rx offers a complete suite
of revenue cycle management services
from beginning to end, including revenue
cycle process consulting, interim management services, insurance follow-up, self-pay
follow-up and Medicaid eligibility.
Dan Hinson
704/553-7144
dhinson@medarx.com
www.medarx.com
MedDirect Inc.
MedDirect’s Patient Pay Solutions program
has become the company’s core service and
exclusive focus. MedDirect starts by treating patients with respect and establishing
communication through initial scheduling
and insurance verification. Communication
touch points then are continued through
problem-solving and follow-up events,
including patient satisfaction surveys.
Eric Becker
616/464-9527
ebecker@meddirect.net
www.meddirect.net
NHPN
NHPN is a national health care revenue
cycle management company focused on
enhancing hospitals’ financial performance.
NHPN designs innovative managed care
programs supported by experienced personnel and technology-enabled service processes to drive increased revenue, cash flow and
operational efficiency. The company offers
a complete suite of managed care solutions
that provide exceptional return on investment, including consulting services encompassing assessment, modeling, negotiation
and ongoing support of managed care
contracts; contract compliance solutions;
and silent PPO service.
Kurt A. Kozin
610/230-0905
kkozin@nhpn.net
www.nhpn.net
Resource Corporation
Of America
Resource Corporation of America, a
provider of third-party eligibility services,
helps hospitals convert self-pay to a paying
status. The firm offers extensive knowledge
of the application, certification and appellate processes for county, state and federal
third-party assistance programs in all 50
states. Patient support representatives,
who conduct thorough patient screenings
to determine eligibility, are augmented by
directors of patient support and back-office
staff who coordinate patient locating/skip
tracing services, home visits, patient transportation, overall patient compliance and
appellate proceedings. Because client communication is vital to a successful program,
the client services’ group provides performance reports as a management tool.
Laurel Waller
281/334-1855
laurelwaller@resource-corp.com
www.resource-corp.com
SquareTwo Financial
Healthcare Funding
SquareTwo Financial Healthcare Funding
is a national purchaser of distressed health
care assets. The company is dedicated to
helping hospitals manage challenging
self-pay receivables and create capital
from assets that have been written off. It
is committed to maintaining a hospital’s
reputation by endeavoring to work only
with law firms that will treat patients with
the respect they deserve. SquareTwo Financial Healthcare Funding’s commitment to
servicing accounts in a respectful manner,
financial strength and national scope make
the company an industry leader in asset
recovery.
Michael Toth
281/251-3445
mtoth@squaretwofinancial.com
www.squaretwofinancial.com
S H A R I N G FA L L 2 0 1 1
5
NEWS ROUNDUP
THA Award
Nominations Due
Each year, the Texas Hospital Association
recognizes its members’ accomplishments
with several key awards. Nominations for
the Earl M. Collier Award for Distinguished
Health Care Administration, the Excellence
in Community Service Award and the Bill
Aston Award for Quality are due by Sept. 30.
The Earl M. Collier Award, the highest
honor bestowed by THA, recognizes outstanding executives who have distinguished
themselves through their contributions to
the health care industry. The Excellence in
Community Service Award honors institutions that have created and supported
innovative programs benefiting the community. The Bill Aston Award for Quality
honors a hospital’s success in improving
quality and patient outcomes through the
sustained implementation of an evidencebased patient care initiative.
Award winners will be featured in THA
publications and recognized at the THA
2012 Annual Conference, Feb. 1-2 in Austin. For more information on these awards,
including eligibility and nomination forms,
go to www.tha.org/awards.
ACS Acquires CredenceHealth
Affiliated Computers Services Inc., a Xerox
company, has acquired Texas Hospital
Association-endorsed CredenceHealth Inc.,
a provider of software that captures and analyzes patient data to help hospitals, health
plans and providers improve quality of care
and compliance with meaningful use regulations. By integrating CredenceHealth’s
clinical surveillance tools with ACS’ core
suite of managed care solutions under the
Midas+ software brand, ACS can offer a
cloud-based solution that actively monitors
patient data. This data is accessible to hospital staff from any Internet browser using a
secure password-protected system.
All CredenceHealth products and
services will be integrated into Midas+
solutions, which help improve staff efficiency, enhance patient safety and increase
hospital profitability. CredenceHealth’s
management team and employees will join
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S H A R I N G / Fall 2 0 1 1
ACS. Justin Lanning, chief executive officer
of CredenceHealth, will serve as vice
president of business development at ACS
Midas+. For more information, go to www.
credencehealth.md.
Nominations Sought for
Country Doctor of the Year
Staff Care Inc., a national health care temporary physician staffing firm, is seeking
nominations for the 2011 Country Doctor
of the Year Award. Now in its 19th year,
the award honors the spirit, skill and dedication of America’s rural medical practitioners. Staff Care is accepting nominations
for the award through Oct. 15.
Staff Care will provide the 2011 Country Doctor of the Year with a temporary
physician for two weeks at no charge so
the award recipient can take time away
from his or her practice. According to Staff
Care President Tim Boes, rural doctors
often cannot find physicians to cover their
practices and therefore have difficulty taking vacations.
“We hope the award winner enjoys
some time off,” Boes said, “but our real
intent is to honor an outstanding country
doctor and to shine a light on the great
work that rural physicians do.”
Nominations will be accepted for
physicians who practice in communities
of 20,000 or less and who are engaged in
such primary care areas as general practice,
family practice, internal medicine and
pediatrics. For more information, go to
www.countrydoctoraward.com.
AMN Healthcare Receives
NCQA Certification
AMN Healthcare, a provider of health
care staffing and workforce solutions, has
earned the Credentials Verification Organization certification from the National
Committee for Quality Assurance. AMN
also holds The Joint Commission’s Health
Care Staffing Services certification.
The NCQA certification provides
health care organizations that utilize
locum tenens providers, sourced through
AMN Healthcare, an assurance that they are
getting the highest quality candidates. This
certification will be initially utilized to support the credentialing services of Staff Care,
an AMN company.
“Achieving NCQA certification is another key differentiator for AMN and Staff
Care,” said Marcia Faller, RN, Ph.D., chief
clinical officer at AMN. “As one of only a
handful of health care workforce solutions
companies to have earned this distinction,
our clients now have further independent
confirmation regarding the value of our
credentialing rigor and thoroughness.”
To achieve certification, AMN underwent a meticulous on-site and off-site
evaluation conducted by a credentialing
surveyor and an administrative surveyor.
AMN’s temporary physicians are verified for
licensing, the Drug Enforcement Agency’s
Controlled Dangerous Substance certification, highest level of education, malpractice
history, work history review, sanctions history search and ongoing monitoring, and
much more. For more information, visit
www.amnhealthcare.com.
General Physics Corporation
Acquires RWD
General Physics Corporation, a subsidiary
of GP Strategies Corporation, has
acquired certain operating assets and the
consulting business of Texas Hospital
Association-endorsed RWD Technologies
LLC, a consulting company that enables
and drives successful business transformations and front-line effectiveness for
Fortune 500 companies. Most of RWD’s
business units will operate within GP as
part of a new RWD Technologies Group,
while other units will be integrated into
existing GP operating groups.
The operational leaders of RWD are
joining GP as part of the acquisition. In
addition, substantially all of the employees
in the acquired operating units have been
offered employment by GP and are remaining with the acquired business. For more
information, go to www.gpworldwide.com. R
The Power of Two: Unique Partnership Creates
Successful Staffing Solution
By Karen Branz
In 2009, Joan Shinkus Clark, RN, FACHE, senior vice president/chief
nurse executive of Arlington-based Texas Health Resources, had a
vision for a new way of staffing the system’s hospitals.
“She wanted to build an internal, flexible resource pool and
create a central, cost-effective, 24/7 staffing organization,” said
Rosemarie Aznavorian, RN, president/chief nursing officer of
Texas Health SingleSource Staffing. “The goal was to ensure a
consistent, stable supply of highly credentialed nurses and
allied health professionals for the system’s hospitals and satellite
facilities.”
Clark’s vision resulted in the creation of THSS, a separate
limited liability corporation. THSS partnered with Nursefinders,
a nurse staffing company that became part of AMN Healthcare
through an acquisition in 2010, in the project. AMN Healthcare is
the nation’s leading provider of comprehensive health care workforce staffing and management solutions.
“This freestanding partnership is the first of its kind in the
country. Joan Clark and others have given presentations on it at
meetings of the American Organization of Nurse Executives and The Healthcare Roundtable as well as at other national conferences because it is a uniquely effective way to staff,” said Aznavorian. The partners share responsibilities, along with affiliated
providers, in filling per diem and long-term openings. THSS fills
positions first, followed next by AMN and other affiliated providers as necessary.
The endeavor has two major functions. First, THSS functions
as a centralized staffing office for Texas Health Resources. Nurses
and allied professionals are assigned based on the needs of the
entire organization, allowing the hospitals to draw on staff from
throughout the system. This means that an opening in one hospital can be filled with staff from another if possible. The second
function of THSS is to maintain a pool of temporary staff who
meet the same credentialing requirements as permanent staff.
“This gives us more control over our temporary staff,”
Aznavorian said. “We know that they hold the same qualifications
as any other medical professional at Texas Health.”
Aznavorian cited several benefits for Texas Health in the
arrangement.
“It’s a very cost-effective staffing model. With a central staffing process across the system, we were able to eliminate duplicate
staffing efforts. And onboarding is easier when it’s done centrally,”
she said. “The central
function also allows
us to track our fulland part-time staff
and be sure that they
are being scheduled
for their required
hours. With increased
needs for nurses and
allied health professionals, this ensures
us the full benefit
of our permanent
staff before we fill
shifts with temporary
staff.”
Additionally,
hiring through THSS
means that all staff
adhere to the promises, values and culture
of the system.
“Outside agencies, which serve multiple hospital clients,
don’t have that singular focus,” Aznavorian said. “In fact, over
the past year, Texas Health has hired 40 of our temporary staff
as permanent employees. That’s a challenge for us as we have to
replace them, but it shows you the quality of the staff we recruit
for the temporary pool.”
Currently, THSS staffs registered nurses; licensed vocational
nurses; patient care technicians; sitters; certified surgical technicians; physical, occupational, speech and respiratory therapists;
and radiology/imaging, pharmacy and laboratory staff. Aznavorian noted that THSS soon will be recruiting for medical clerical
staff as well.
“This venture has been very successful. During startup, AMN
supplied a significant portion of our temporary pool. As we have
ramped up, THSS is successfully growing its own pool, thereby
reducing reliance on agency staff,” she said.
For more information about AMN Healthcare, contact
Bonnie Owens at bonnie.owens@amnhealthcare.com or 877/
282-0380 or go to www.amnhealthcare.com. R
S H A R I N G / Fall 2 0 1 1
7
Pharmacy Staffing: On-Site and Remote Solutions
for Rural Hospitals
By Terri Schexnayder
Charles Norris, chief executive officer of Gonzales Healthcare Systems,
understands the unique challenges hospitals in smaller communities
deal with on a daily basis. Chief among these is managing pharmacy
operations. In 2009, the Texas Legislature debated whether hospitals
should be required to have a pharmacist on-site 24/7 with prospective
order review – a situation that was not feasible for many rural facilities.
That year legislators passed legislation requiring more supervision in
rural and critical access hospital pharmacies.
ment. One might not know if an error occurred unless it negatively
impacted the patient,” he said.
“It’s going to be very tough if the state continues to press the
need to have a pharmacist on-site, especially when so many entitlement programs are being reduced and money is being cut,” Norris
said.
In addition to operation and management services, HPS recently
introduced a patent-pending product called the Remote Prescription Approval System. Designed to bring pharmacists into the
hospital through state-of-the-art technology, RePAS provides
electronic supervision of staff technicians. This innovative service
provides a cost-savings solution allowing technicians to be supervised by a remote pharmacist if the facility is licensed
for 100 beds or fewer.
Gonzales Healthcare Systems addresses its
pharmacy needs by partnering with Hunter
Pharmacy Services Inc. HPS’ fully managed
pharmacy program provides the facility
with an on-site pharmacist who works five
days (40 hours) a week.
The partnership between Gonzales
Healthcare Systems and HPS, which began
approximately 15 years ago, has resulted in strong
client satisfaction and a cost-efficient way of doing
business in South Texas. Gonzales Healthcare Systems can
depend on the expertise and professionalism of the program’s
on-site pharmacist. Additionally, pharmacy technicians and
nurses cross-check each other to monitor each patient’s medical
history and the dispensing of drugs, resulting in streamlined quality
control – and peace of mind for Norris.
“You certainly can make the case that this way of doing business is a far better model than the way rural hospital pharmacies
were run. For at least eight hours a day, five days a week, you are
providing your patients with the highest level of competency as
you can,” Norris said.
Michael Hunter, president/CEO of HPS, founded his Austinbased company in 1987. Hunter and his staff continuously strive to
improve client pharmacy operations by exceeding customer expectations and providing smart, cost-saving solutions. Hunter has seen
a lot of changes in rural hospitals over the years.
“Basically, many of these hospitals at that time had a drug
room – the pharmacy – that was in disarray. They did not have the
systems in place for optimal patient care or medication manage-
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S H A R I N G / Fall 2 0 1 1
HPS offers a cost-effective means to alleviate the burden of
tightened regulations along with staffing shortages. The company
provides a high-quality operation compliant with all regulatory
agencies and strives to reduce costs while ensuring patient safety.
Virtual Pharmacists
“HPS is able to provide electronic supervision through real-time communications and
high-resolution digital images of the functions
performed within the pharmacy,” said Hunter.
“These images are transmitted to the RePAS
pharmacist for review, verification and approval
prior to the patient receiving therapy. Once
approved, medication is then dispensed from
the pharmacy.”
The high-resolution audio/visual equipment allows for ongoing
live interaction between the RePAS
pharmacist and the pharmacy staff as well as the transmission of
digital images. Every image is tagged and archived for two years in
order to meet state and federal regulations and can be retrieved if
necessary. This service is definitely an option Norris will consider.
“The advantage to this new program is that you would further
cut down on pharmacy human error with several people simultaneously looking at every prescription being dispensed,” Norris said.
“And with HPS’ reputation behind all its products, our health care
system can only benefit from this investment.”
For more information about Hunter Pharmacy Services,
contact Dawn Rana at dawncrana@gmail.com or 210/737-4961 or
go to www.hunterpharmacy.com. R
Focus on Compliance: Improving Documentation,
Bringing Up the Bottom Line
By Geoff Camphire
Baptist St. Anthony’s Health System, like many hospitals, was
looking for a way to enhance the accuracy of its case-mix index.
To improve BSA’s CMI – the average diagnosis-related group weight
for its Medicare volume – hospital staff couldn’t just target the
required coding. They had to ensure regulatory compliance of the
clinical documentation behind that coding, said Michelle Mayes, the
Amarillo facility’s director of corporate compliance.
“Our original goal was not financial; it was compliance,” said
Mayes. “When you’re compliant, it pays. And that’s all we want to
be. We want every dollar owed to us, not a dollar more.”
To ensure compliance, BSA enlisted the help of J.A. Thomas &
Associates, a documentation improvement firm commonly known
as JATA. JATA, which has helped more than 500 hospitals strengthen documentation over the past 20 years, typically finds opportunities for improvement in 20-25 percent of a hospital’s records.
“Hospitals deliver good care,” said Mel Tully, JATA’s senior
vice president of clinical services and
education. “But there can be millions
of dollars a year that hospitals are not
receiving because they simply don’t
document accurately the care they
deliver.”
Since 2003, BSA has used JATA’s
Compliant Documentation Management Program, which features technology tools, training and ongoing
support. CDMP ensures that records
contain the compliant language
needed to support the care provided,
which ensures appropriate reimbursement and avoids the risk of audit
liability. Results typically include a
4-8 percent increase in CMI, improved comparative performance
reports, enhanced compliance and more appropriate reimbursement, according to JATA.
“Our CMI on our reviewed charts has improved dramatically,”
Mayes said, “and we’ve been able to not only improve it but also
sustain it.”
With more than 60,000 charts reviewed, BSA has improved
its CMI for those cases from 1.51 at the start of CDMP to 1.72 last
year. For perspective, consider that the average CMI for hospitals in
BSA’s peer group is 1.60, according to Medicare Provider Analysis
and Review benchmarking data.
Beginning with an assessment of records and documentation
needs, CDMP tackles every aspect of the documentation process.
Unlike retrospective coding-based programs, CDMP allows doctors
and nurses to accurately document each case from the time the
patient enters the hospital. Documenting bedsores on admission,
for example, can be important for making clear that the condition
was not acquired in the hospital. Follow-up visits by JATA physicians allow valuable interactions with hospital physicians.
“You can get a better response from physicians when you
have another physician talking to them,” Mayes said. “It’s peerto-peer communication: ‘Here’s what this means to you, the
physician, and your bottom line.’”
Regulations require physicians to document cases in specific
ways – no shortcuts.
“Coders can’t interpret anything; they can only go by the
written word,” Mayes said. “Sometimes it’s as minute as an up arrow for saying, ‘Increased potassium.’ They can’t interpret the up
arrow. It has to say ‘increased.’ That’s just
the rule.”
For BSA, the process is ongoing.
“Once a year Medicare is going to
change the rules, so we’re constantly
changing and having to learn,” Mayes
said. “That’s the advantage that we get
from JATA: We’re up-to-date and current
because they provide us with that information. We don’t have to go out and
research all of the changes on our own.”
JATA continually monitors and manages the program at BSA to ensure that
physicians, nurses, coders and administrators understand and use it successfully.
In addition, the Atlanta-based company benchmarks hospital
progress against that of similar hospitals and industry best practices. Ultimately, these efforts make hospitals more competitive.
“Clinical documentation drives public report cards,” Tully
said. “If you’re looking at hospitals in a very competitive market
that are vying for patients, public reporting is prevalent in the
industry now. Consumers can look very easily at how hospitals
stack up against each other.” And what they want, she added, is
documented evidence of quality care.
For more information about J.A. Thomas & Associates, contact Melissa Dickinson at melissa.dickinson@jathomas.com or
770/438-8537 or go to www.jathomas.com. R
S H A R I N G / Fall 2 0 1 1
9
tHE BottoM lINE
Majority of Physician Jobs
Feature Hospital Employment
The majority of job openings for physicians
today feature hospital employment while
openings for private practice doctors are
fewer and farther between, according to a
new survey by national physician search
firm Merritt Hawkins, an AMN Healthcare
Company.
The firm’s 2011 Review of Physician
Recruiting Incentives tracks more than 2,660
physician recruiting assignments Merritt
Hawkins conducted nationwide from April
1, 2010, to March 31, 2011. During that
period, 56 percent of the physician search
assignments featured jobs with hospitals,
up from 23 percent five years ago. Only 2
percent of the firm’s search assignments
featured openings for independent, solo
practitioners, down from 17 percent five
years ago.
“The era of the independent physician
who owns and runs his or her practice is
fading,” said Travis Singleton, senior vice
president of Merritt Hawkins. “Doctors
today are more likely to be employees working for increasingly large health systems or
medical groups.”
The survey also indicates that primary
care physicians, including family physicians and general internists, remain the
type of doctors in highest demand. For the
sixth straight year, family physicians were
the firm’s most requested type of doctor,
followed by internists, hospitalists, psychiatrists and orthopedic surgeons.
Complete results of the survey can
be obtained by calling Merritt Hawkins at
800/876-0500.
Study: ACO Start-Up
Costs Significant
The start-up investment required to establish and sustain an accountable care
organization is considerably higher – $11.6
million to $26.1 million – than the $1.8
million estimated by the Centers for Medicare & Medicaid Services, according to a
study released by the American Hospital
Association.
“CMS’ estimate falls short of the
mark,” said Rich Umbdenstock, FACHE,
AHA president and chief executive officer. “The shared savings rate with ACOs
should be adjusted to reflect these costs in
order to encourage and enable participation in this important program.”
The cost findings are based on 23
different capabilities that ACOs need to
develop across four categories: network
development and management; care
coordination, quality improvement and
utiization management; clinical information systems; and data analytics.
The study is based on a series of case
studies of organizations that have taken
steps to manage the care of a defined
population in a manner similar to that
of an ACO. For more information, go to
www.aha.org/ACOcasestudies. R
HEAltHSHARE HIGHlIGHtS
THA Endorses Three
New Companies
The Texas Hospital Association recently
endorsed three more companies: CSI
Leasing (technology equipment leasing),
HealthXnet (health care information
clearinghouse) and LoneStar MSO (practice
management services). For more information on these or any other THA-endorsed
companies, call 512/465-1070 or go to
www.healthshare-tha.com. R
Look for HealthSHARE representatives
at these upcoming events:
Oct. 10 -11
Feb. 1-2, 2012
Texas Health Law Conference
Austin
Texas Hospital Association
2012 Annual Conference
Austin
THA Annual 20
Conference 1 2
texas hospital association
February 1-2
Austin convention center
10
S H A R I N G / FA L L 2 0 1 1
Texas Hospital Association-Endorsed Companies
Air Liquide Healthcare America Corp.
www.airliquide.com
Brian Twohig, 512/233-9879
Curbside Hospitality
www.curbside.com
David Ryan, 978/524-0900, ext. 101
Management Dynamics Inc.
www.management-dynamics.com
Richard “Dick” Nolan, 770/953-9553
SpectraCorp
www.spectracorp.com
Christina Orlando, 800/375-7945, ext. 321
Amazon Coding
www.amazoncoding.com
Jan Keil, 888/442-6296, ext. 801
Discovery Health Record Solutions
www.discoveryhrs.com
Richard Russell, 913/681-2430
MedA/Rx
www.medarx.com
Dan Hinson, 704/553-7144
American Medical Alert Corp.
www.amac.com
Paul Lieberman, 214/425-2622
DOTmed.com
www.dotmed.com
Philip F. Jacobus, 212/742-1200, ext. 250
MedDirect Inc.
www.meddirect.net
Eric J. Becker, 616/464-9527
*SquareTwo Financial
Healthcare Funding
www.squaretwofinancial.com
Michael Toth, 281/251-3445
*Amerinet
www.amerinet-gpo.com
Rafael Rodriguez, 817/600-1743
*eTactics Inc.
www.etacticsinc.com
Paul Osiecki, 214/213-1685
MedImpact Healthcare Systems
www.medimpact.com
Jill Simoes, 858/790-3084
Ameritas Group Dental & Eye Care
www.ameritasgroup.com
Craig Miller, 888/968-9365
Financial Review Services Inc.
www.checkfrs.com
Mike Lewis, 713/850-7456
MedTravelers
www.medtravelers.com
Landry Seedig, 972/830-4407
*AMN Healthcare
www.amnhealthcare.com
Bonnie Owens, 877/282-0380
*General Physics
www.rwd.com
Sue Martin, 248/267-3536
MEMdata LLC
www.memdata.com
Andy Hood, 866/695-1950, ext. 105
Armko Industries Inc.
www.armko.com
Kim Calloway, 888/874-1388
*GroupOne Services Inc.
www.gp1.com
Kim Hines, 469/648-5051
*Merritt Hawkins
www.merritthawkins.com
Jeff Faulkner, 469/524-1584
Auditz LLC
www.auditz.com
Jeff Johnson, 813/387-0317
HealthCare Benefits Inc.
www.hcb-inc.com
Robert Holland, 800/872-0277
*Milliman
www.milliman.com
Doug Conkel, 214/863-5112
*Bells International Inc.
www.bellsintl.com
Shawna Plumb 888/440-4649, ext. 215
Healthcare Recovery Alliance
www.hcralliance.com
Mike Stewart, 800/710-2825
*CampbellWilson
www.campbellwilson.com
Manie Campbell, 800/723-6492
*HealtheCAREERS Network
www.healthecareers.com
Gary Seaberg, 214/256-4811
National Benefits Group
of America Inc.
www.nbgamerica.net
David Brogan, 800/330-7735
*CareFusion
www.carefusion.com
Chad Glover, 205/314-8636
HealthXnet
www.healthxnet.com
Brett Weinstein, 505/346-0222
*Carrier Corporation
www.carrier.com
Todd Van Hyfte, 972/789-3420
*Hospital Receivables Service Inc.
www.hospitalreceivables.org
Doug Smith, 800/955-8722
COBRAGuard Inc.
www.cobraguard.net
Cathryn Scivicque, 800/442-6272, ext. 4862
Hunter Pharmacy Services
www.hunterpharmacy.com
Dawn Rana, 800/707-8799
*Columbia Healthcare Analytics Inc.
www.columbia-analytics.com
Penny Jadwin, 888/465-7692
*ID Theft Solutions of America
www.idtsoa.com
Kevin Putnam, 800/735-4850, ext. 1
*Commerce Bank N.A.
www.commercebank.com
Lance Wright, 800/892-7100, ext. 27094
*InsMed Insurance Agency Inc.
www.insmedinsurance.com
Jeff Girr, 800/214-7039
*Commerce Bank Merchant Services
www.commercebank.com
Christer Hanson, 800/892-7100, ext. 22303
Integrated Revenue Management
www.irminconline.com
Thomas E. Wolfe, 760/448-1039
*Concerro Inc.
www.concerro.com
Keith Wagstaff, 210/347-7425
J.A. Thomas & Associates
www.jathomas.com
Bette L. Cloud, 800/683-8734, ext. 0683
Craneware Inc.
www.craneware.com
Jacob Nguyen, 602/684-3099
Jackson-Lloyd Insurance Mgmt.
www.jackson-lloyd.com
Thomas D. Lloyd, 800/657-5242
CredenceHealth
www.credencehealth.md
Jeffrey Persson, 615/712-2213
LoneStar MSO
www.lonestarmso.com
Bill Cook, 214/345-1423
NHPN
www.nphn.net
Kurt Kozin, 610/230-0905
*Nielsen Healthcare Group
www.nielsenhealthcare.com
Craig Venneman, 800/581-8901
NorthStar Anesthesia
www.northstaranesthesia.com
Diann Litsch, 682/227-6847
O’Grady Peyton International Inc.
www.ogradypeyton.com
Sinead Carbery, 888/570-0038
*Press Ganey Associates Inc.
www.pressganey.com
Randy Swift, 817/682-2015
*Priority Power Management
www.prioritypower.net
Perry Ruthven, 713/320-7232
*Resource Corporation of America
www.resource-corp.com
Laurel Waller, 281/334-1855
*Staff Care Inc.
www.staffcare.com
Chris Schleiss, 800/685-2272
Tandberg
www.tandberg.com
Ryan Rogers, 512/505-8900
TEDS
www.teds.com
Todd Mauldin, 601/988-4677
Texas Hospital Association
Insurance Programs
www.healthshare-tha.com
Rob Madsen, 817/372-1305
Texas Hospital Association
Patient Data System
www.tha.org/pds
Kent Stevens, 800/252-9403
Texas Hospital Association
Retirement Plan
www.healthshare-tha.com
Fred Hamilton, 800/252-9404
Texas Hospital Insurance Exchange
www.thie.com
Liz Jennings, 800/792-0060, ext. 525
*Thomson Reuters
www.thomsonhealthcare.com
Walter Rosenthal, 704/321-0101
*Tyler & Company
www.tylerandco.com
Nelson Mann, 512/266-8739
*UMR
www.umr.com
Lynda Jacobson, 281/256-7492
*Verge Solutions LLC
www.verge-solutions.com
Barbara L. Norman, 408/227-1314
*Wiederhold & Associates
www.wiederholdassoc.com
Jim Wiederhold, 888/556-2621
*Texas Healthcare Trustees-endorsed
RWR Financial Services Inc.
Bob Rhodes, 877/246-9377
Rx Pro Health
www.rxprohealth.com
Shannon Boren, 866/960-5340
*Ryerson Healthcare Consultants
www.rmasolutions.com
David Dildy, 903/343-2900
S H A R I N G / Fall 2 0 1 1
11
P.O. Box 679010
Austin, TX 78767-9010
Address Service Requested
You provide world-class health care.
We provide the business partners to help.
Efficiently delivering world-class health care is no easy feat.
That’s why HealthShare partners with the best companies
in the marketplace to bring you leading-edge products and
services – at prices you won’t find elsewhere. Through
HealthShare, you can access dozens of companies handselected through rigorous due diligence as THA-endorsed
companies for their world-class business offerings.
Find out how THA-endorsed companies can help
your hospital lower costs, improve operations and
enhance health care in your community.
Contact HealthShare today!
Mailing: P.O. Box 679010 • Austin, Texas 78767- 9010 • Physical: 1108 Lavaca, Suite 700 • Austin, Texas 78701
512/465-1070 • 800/252-9404 • www.healthshare-tha.com
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